Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 2008-01041 | NC |
NPI | 1255598736 |
---|---|
Provider Name | Dr. Brian Stuart Coan |
First Address | Cary, NC 27513-5512 |
Second Address | Cary, NC 27513-5512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 18/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2023318 | MEDICARE PTAN (01) | NC |